“about making comprehensive change” for trans people
23May2009 Filed under: Gender Identity, Gender Variant, Transgender Author: Cole KrawitzI’m finally posting a few stories that were in the cue. We’ll start with France. This was huge. Last Saturday, the night before International Day Against Homophobia and Transphobia, France became the first country in the world to no longer classify trans identities as a mental illness. Advocates in France have been putting the pressure on for awhile now to have this changed, and a handful of public figures also called on the World Health Organization (WHO) to change their classification. The full article was translated, and I’m posting it below.
Transsexualism will no longer be classified in France as a mental illness, a government decision hailed Saturday as “historic” by the associations concerned, on the eve of the International Day Against Homophobia and transphobia.
The Minister of Health, Roselyne Bachelot, has appealed “in recent days” to the High Authority of Health in order to make a decree that transsexualism be removed from the category of psychiatric disorders, a spokesman for the department stated.
Until now, transsexuals benefited from a fee waiver for their medical care by being classified under ALD23 (affection de longue durée 23 – long term condition 23) for “recurring or persistent disorders”.
For the Department of Health, it is a “strong signal sent to the whole community”, since transsexuals felt that being included under the ALD23 was stigmatizing.
This classification, arising from that of the World Health Organization (WHO), was also linked to the fact that transsexualism appeared on the list of pathologies identified in the DSM (Diagnostic and Statistical Manual of Mental Disorders) to which the medical profession refers, as was the case for homosexuality a few years ago.
In a forum published in Le Monde (newspaper) dated Sunday-Monday, numerous personalities including first secretary of the Socialist Party Martine Aubry, the communist Marie-George Buffet, Green (party member) Daniel Cohn-Bendit and even Nobel Prize winners such as Françoise Barré-Sinoussi (medicine) and Elfriede Jelinek (literature), asked the WHO “to no longer consider transsexuals as being affected by a mental disorder”.
It is because the WHO decided on the 17th of May 1990 to remove homosexuality from the list of mental illnesses, that this date has been retained for the International Day Against Homophobia and transphobia, celebrated Sunday, starting Saturday in many places.
It is therefore symbolic that France chose this time and date to be “the first country in the world” to “remove transgender identity from the list of mental diseases”, commented the IDAHO Committee. This “historic decision” is also “an explosion of hope for all trans persons around the world”, according to Joël Bedos, secretary-general of the IDAHO Committee.
The HES (Association for Homosexuality and Socialism) also “hailed” this announcement which is in response to “demands that the LGBT community have been making for a long time in France.” For HES, it is time, at present, to go beyond the symbolic and take concrete actions to fight against the violence and discrimination facing trans persons.
Because beyond “this measure for declassification, there is still much to be done before transsexuals (…) are recognized as full-fledged citizens”, insisted the coordinator of the group Inter-LGBT.
Two days later, on Monday May 19th in the United States, activists were both inside and outside of the American Psychiatric Association’s (APA) annual convention in San Francisco, presenting to attendees (by Dr. Kelley Winters), and protesting outside, calling for the reform of gender identity related diagnoses.
Judy Berman on Salon.com reported:
“We got homosexuality out of the DSM because of protests at the APA,” [Ehrensaft] told Psychiatric Times. “Now it’s time to do the same with GID.” She also noted that a movement within the association is moving toward a “more balanced” Task Force. With psychologists and activists working together to reform the APA’s position on gender identity, it may be only a matter of time before we stop labeling perfectly sane transpeople mentally ill. Imagine that!
Ruby Cymrot-Wu, a local Bay Area LGBTQ Jewish organizer protested outside the APA convention:
Last Monday, I participated in a protest as part of the larger fight for liberation from institutional gender oppression. I was honored to be part of something so powerful. We called for the APA to recognize gender identity and expression as natural human variation, not as disease or mental illness to be systematically diagnosed. Activists from all over the country, including several queer, genderqueer, and trans-identified health care professionals, took up the megaphone in a collective cry for justice from institutional discrimination. In a time when the debate about access to services for LGBTQ people is often only in terms of how it relates to marriage rights, the GID rally was truly refreshing and empowering for me. Access to high-quality, holistic health care is a must. I hope my work as an activist and advocate for LGBTQ people in the Jewish community creates room for dialogue about making comprehensive change, like health care reform, rather than continuing to pour resources and energy into efforts that secure rights for only some of us.
4 Responses to ““about making comprehensive change” for trans people”
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Tovah
May 24th, 2009 at 4:06 pm
Great, so transsexuality is no longer an illness… and therefore transpeople cannot get their care covered by insurance. How is that progress? While some trans people fight for the right to gender-related health care, other trans people fight for them to no longer be able to access that health care. I get that one could argue transsexuality is not an illness – But doing so in order to get the DSM to declassify it, without providing and implementing an alternative that will ensure medical coverage of transition-related healthcare, is shortsighted and will hurt more people than it helps.
Madeline Deutsch, MD
May 25th, 2009 at 2:01 am
We are working to remove GID from the paraphilia section, and to remove alltogether the diagnosis of transvestic fetishism, as only a sexist would say that a man who wears women’s clothes is mentally ill, yet women who wear men’s clothes are accepted in society and not in the DSM at all.
We are NOT looking to remove the diagnosis of GID alltogether. There are several options, two of which I mentioned in my talk, as did most of the other speakers. Options include moving this to the DSM section on adjustment disorders, or removing it from the DSM but keeping it in the ICD-9/10.
Madeline Deutsch, MD
May 25th, 2009 at 2:04 am
I’m sorry but I just have to add one more comment. Tovah, I’ve dedicated alot of my life to fighting for, and providing access to trans healthcare services. I hardly agree that myself, or any of the other physicians, mental health providers, social workers, and community activists who planned, participated in and attended this rally, and who work in this movement, are in your words fighting for trans people to no longer be able to access health care.
Henry Hall
May 25th, 2009 at 8:07 pm
Opinions vary as to the way forward of course. De facto what has happened is that the medical profession has treated transsexual people badly by promoting their scientific experiments even where human rights are violated and health is damaged. A realization is needed that medicine exists to promote health, not to promote science (the DSM is of course a manual of science not of a manual of health).
The result is that activist transfolk, having been unsuccessful at persuading medicine to mend its ways turn now to the political machine, witness first Sweden, and now France. It doesn’t end here. If transsexualism is not removed by the psychiatrists from the field of mental health it will be removed by heavy handed government edict.
When medicine finally realizes that its very purpose is to promote health, not to promote science, then there will come a sea change of realizing that medical sex is not scientific sex, but rather medical sex is whatever is thought to promote health. Medical sex is a matter of physician judgment, nothing more, and is subject to revision and change. Transfolk will be treated on a same-sex basis in their new sex instead of on a cross-sex basis in their old sex.
What this means is that a transman will not be diagnosed as a woman with a personality disorder but rather as a man without a penis. Different diagnosis, same treatment.
To suggest that treatment will end because psycho-nonsense is debunked is mere scaremongering. Proven successful treatments are not going to go away merely because the theory that justified the treatment is discredited.
The realization that medical sex is not the same as scientific sex and that change comes through the political process is already in motion. IT IS UNSTOPPABLE NOW.